For many conditions, multiple competing treatments are available, many of which have been assessed in randomized trials. Clinicians and patients who are making medical decisions need to know which treatments work best among all treatments available for the condition of interest. They increasingly use meta-analyses that synthesize the results of randomized trials to inform the relative efficacy and safety of the different treatments.

But conventional meta-analyses do not provide an exhaustive up-to-date synthesis of all available treatments, and thus prevent from answering easily to the real questions of interest.

We propose to switch:

  • from a series of conventional meta-analyses focusing on specific treatments (many treatments being not considered), performed at a given time and frequently out-of-date
  • to a single systematic review and evidence synthesis (with meta-analyses and network meta-analyses) covering all treatments and systematically updated when new trial results become available

We call this approach “live cumulative network meta-analysis